CareRooms: the perils of “Silicon Valley hype” when your customer is the NHS

A cautionary tale of an innovator likely sidelined due to clumsy press talk. The NHS has a problem called bed blocking, where post-acute care patients cannot return home because no one is there to care for them. It was up 40 percent last year. One approach to it has been home/community care combined longer term with telehealth services to reduce unneeded re-admissions. Another is freeing up the bed by placing a patient who does not need direct nursing care in a supervised post-acute room in a setting which provides assistance services.

In the US, many large hospitals and clinics run or partner with hotel-like annexes for recovering patients, usually post-surgical, who need assistance but not direct nursing care or special medical monitoring. The patient remains overnight or for a few days, with or without a private duty nurse, until the person can be discharged to travel home. These recovery centers/hotels, plain to plush, are popular in ‘medical tourism’ cities such as Miami, Houston, and New York, but well-used by locals for many procedures including orthopedic and cosmetic surgery recovery. Regular hotels have also gotten into this act with special services marketed to surgical practices. Recovery hotels and services may or may not be covered by insurance as they are part of hospital or practice referral.

CareRooms’ approach is closer to ‘Airbnb for post-surgical discharge care’. Here this startup, according to its website, arranges rooms in private homes for a fee, equips them appropriately, and the lessor can earn £50/night. The host stays on the premises, microwaves meals and serves drinks, and can be sociable. Other care is provided by CareRooms. The idea is simple, eminently pitchable, and may actually address this NHS problem usefully if supervised properly. The co-founder and medical director of CareRooms, Harry Thirkettle, is a part-time A&E registrar at Southend and was mentored in the NHS Clinical Entrepreneur program; the other co-founder was a program mentor.

And therein lies the catch. The service has not been in trials yet, and here they are offering room lessors without care training £50/night right on the website, which gives the impression that this service is readily available (wrong). How do they provide their ‘other care’ and what is it? How do they equip the room? Recruit and train hosts? How will they scale three rooms to 30 and then 300? And payment–covered or private? All those problematic, unglamorous and sobering things founders learn in early days haven’t been experienced yet.

Kicking off the firestorm was CareRooms’ Mr. Thirkettle talking up a pilot with Southend University Hospital Foundation Trust in the Health Service Journal. It turned out it was one of several approaches being considered by the hospital trust. CareRooms possibly felt confident as it was leafleting the public and had a stall in the hospital restaurant. The Southend management quickly walked back any commitment. Southend Council was also engaged–and did the same.

The breathless news storm around CareRooms has reached the usual suspects such as WIRED and the Guardian. Particularly overheated was a second article in the Guardian by an NHS physician who called it ‘human warehousing’ and apparently objects throughout to any privately funded solution to NHS problems, while abashedly admitting that her hospital has a Ronald McDonald House for families. (Oddly, to this Editor, a far more sensible and controlled solution would be US-style post-acute recovery hotel with services, which would free up an acute care bed in a day or two at lower cost, and provide appropriate care.)

Loose Lips Sink Ships. In reading this agglomeration of hostile opinion, CareRooms’ cardinal sin was a marketing one–the founders let their PR get ahead, way ahead, of their reality. Their ‘hype’ was hardly ‘Silicon Valley’ (think Theranos) spin quality. CareRooms was in that awkward state called ‘pre-pre-marketing’, which means you keep a very low profile to the press, develop the product, get funding, and concentrate on relationship building. Especially with the NHS, discretion is a virtue through the system. Funding for NHS services and privatization is the hottest of hot buttons. Constituencies such as doctors need to be wooed, else they rise to object almost immediately, such as the Save Southend A&E campaigners. The mostly self-inflicted blowback may doom a testable, but perhaps not workable, idea–and put a wet blanket on the innovation that the NHS is actually attempting to foster. Hat tip to Susanne Woodman of BRE.

Our definitions

Telehealth and Telecare Aware posts pointers to a broad range of news items. Authors of those items often use terms 'telecare' and telehealth' in inventive and idiosyncratic ways. Telecare Aware's editors can generally live with that variation. However, when we use these terms we usually mean:

• Telecare: from simple personal alarms (AKA pendant/panic/medical/social alarms, PERS, and so on) through to smart homes that focus on alerts for risk including, for example: falls; smoke; changes in daily activity patterns and 'wandering'. Telecare may also be used to confirm that someone is safe and to prompt them to take medication. The alert generates an appropriate response to the situation allowing someone to live more independently and confidently in their own home for longer.

• Telehealth: as in remote vital signs monitoring. Vital signs of patients with long term conditions are measured daily by devices at home and the data sent to a monitoring centre for response by a nurse or doctor if they fall outside predetermined norms. Telehealth has been shown to replace routine trips for check-ups; to speed interventions when health deteriorates, and to reduce stress by educating patients about their condition.

Telecare Aware's editors concentrate on what we perceive to be significant events and technological and other developments in telecare and telehealth. We make no apology for being independent and opinionated or for trying to be interesting rather than comprehensive.